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Arizona is ready for repeal and replace as premiums keep rising


We can’t stop now, Arizona. We need to continue the conversation about repealing the disastrous health care system called the Affordable Care Act (ACA), aka Obamacare. While dialogue about a bipartisan effort to draft a new bill may be the feel-good news of the moment, it must be known that this kind of effort will end up propping up the current law and further entrench the current failing system of Medicaid.

But we can’t keep stalling. If the congressional GOP truly wants repeal, as they’ve repeatedly championed, their first step is to show strength in numbers and be a majority that can take action for families that are desperate for change. While not perfect – incremental changes rarely are – the Better Care Reconciliation Act (BCRA) would have taken us leaps toward that goal by freeing Americans from the ACA’s onerous mandates and taxes.

Nancy Barto

Nancy Barto

As expected, the health care and insurance lobbies had a field day of grave consequences. What was not expected was the failure of our senators to weigh faulty predictions against the actual harms the law is causing Americans today!

Betrayed by the promises of lower premiums and the ability to keep their doctors, families now have insufferably narrow networks, pay multiple times more for less care and many have been forced into exchanges where there are few, if any, carriers. Individuals like John in north Phoenix paid $422 monthly in 2016 for a family bronze plan that increased to $1,038 this year. Kim, a business owner in Casa Grande, had to close an office location, lay off 20 employees and close 10 positions. With talk of millions potentially “losing coverage” under repeal scenarios, these families are paying a high price for inaction every day. These are not anecdotal cases. Since 2010, Arizona has seen a 45 percent net reduction in employer insurance offered by small businesses, according to data from the Agency for Healthcare Research and Quality.   Importantly, the Senate bill would also have taken the small but critical first step of slowing the growth of Medicaid, the expansion of which is a central component of Obamacare. Medicaid would continue to grow about 2 percent per year, but at least we’d be acknowledging that entitlement spending is driving our debt crisis and making efforts to address it. Incredibly, one in four Arizonans is signed up for the Arizona Health Cost Care Containment System (AHCCCS) and is growing by double digits annually. And for all its cost efficiencies, AHCCCS needs its own reforms to ensure that the vulnerable seriously mentally ill, children in foster care and developmentally disabled individuals don’t fall through the cracks. Other negative consequences remind us that the ACA is an incoherent law that was designed to fail and lead to the Left’s ultimate goal – single payer. It leaves physicians under-reimbursed and over-worked with bureaucratic paperwork. The result? Almost half plan to quit, change job positions or reduce hours, according to the 2016 Survey of America’s Physicians.

Arizona is ready to rid itself of the burdens of the ACA. Without its constraints, we are poised to enable a real marketplace of health care options for families – where innovation, competition and transparent prices for health care services could come together to stem health care costs. Broader use of medical savings accounts, health care sharing and direct care models, along with bold innovations we have yet to imagine, would allow individuals and their doctors to drive their health care decisions for the first time in a generation – rather than third-party bureaucrats. Americans deserve to know if the congressional GOP is committed to getting the federal government out of their health care decisions, as they have espoused. If so, one thing is for sure – it will demand the herculean effort of listening to the American people – not the health care industry and insurers.

Sen. Nancy Barto, R-Phoenix, is chair of the Senate Health and Human Services Committee


The views expressed in guest commentaries are those of the author and are not the views of the Arizona Capitol Times.


  1. I’ts clear to anyone who understands numbers and how insurance works that the ACA is not anything like the “disaster” that Ms Barto claims. In fact it’s working exactly as intended wherever Republicans are not sabotaging it, according to every fair study. The core problem with the ACA is that it relies on insurance companies to not act like rapacious profit-sucking monsters, which I admit was somewhat unrealistic. But it proves to me and, apparently, a clear majority of Americans that we have to support the effort to ensure that all Americans are protected from the essentially automatic personal bankruptcies that have plagued Americans in their middle and later years when they have the misfortune to fall seriously ill. (This happens frequently to both insured and uninsured people, obviously.) By continuing to sabotage the system, Republicans including Ms Barto are actually helping to push us in the right direction, which is to remove the insurance companies from the mix and expand on our successful Medicare system by extending it to all. We’re ready and eager to join the rest of the developed world in a health-care system designed for people, not profit. Will it be perfect? No, of course not. Will it be better? Yes.

  2. This is tacky. Sen Barto is making a politically derived statement as if it is commentary. She should stick to the campaign format. The idea the Obamacare is a complete failure has been refuted by too many reliable sources to be anything less that Republican pandering. The failure to fix the parts that need fixing is due to the fact that Republicans have no plan because they have never wanted universal health-care. The system that refuses, distinguishes and fails too many was just fine with them. They are helpless now because the masses have seen something better and will not allow a Republican backwards move.

  3. One of the worst fallouts from the ACA has been the conflation of “insurance” and “charity.” Insurance is the pooling of risk by those subject to that risk in order to protect themselves from financial disaster. Charity is providing financial or other assistance to people that need something they can’t afford. Mixing these two wildly different concepts causes all sorts of problems, as well as misunderstandings.

    Mandating coverage for “pre-existing conditions,” for example, is akin to selling fire insurance to someone whose home has already burned down. That’s not insurance. it’s charity.

    The problem with so-called “universal health care” (“single-payer”) is that whoever controls the money also controls the service and access to it. We all know how difficult it is to get government to do the right thing, do we really want to have to go through the perverse, corrupt political process for something as important as our health care? Control of your relationship with your doctor would be at the mercy of self-serving politicians, uncaring career beaurocrats and the huge health care conglomerates that buy them off using YOUR tax money.

    The federal government has no Constitutional authority to regulate or provide health care or medical insurance. If we go down that road we should at least amend the Constitution to grant it that authority rather than allowing Washington to continue to do any damn thing it pleases with impunity.

  4. It is a matter of degree. If people banded together for insurance based solely on risk, insurance would cease to exist. But you are right. This debate boils down to whether you think we should take care of those unable to take care of themselves. In deciding this, I remember that “for the grace of God, …” One is sometimes healthy because of good decisions, but mostly it’s a matter of luck. …. The fear that single-payer leads to someone calling the shots is misguided, in my opinion. Right now, the people calling the shots are doing so with only one purpose in mind: profit. As a practitioner, I billed insurance companies, and watched them gradually take over health care decisions. Recently, my wife’s doctor told us “doctors don’t make the decisions any more, insurance companies do”. By comparison, the govt works for us, not the profiteers. (I know, we need to gain control of govt, but that is a different topic.) I would rather have someone who works in my best interest making decisions, rather than someone only interested in profit.

  5. Government interference in the health care market since World War II created the environment in which insurance companies are able to exercise the type of control you describe, Mr. Hudson. Medical groups and large insurers are some of the biggest spenders on political lobbying to make sure that the system continues to favor them and prevent real price competition.

    Consider the relatively unregulated LASIK procedure for vision correction–a procedure that is not covered by health insurance. In the last ten years, prices for LASIK have dropped from an average of $2,500 per eye to around $300 per eye. During that same period, heavily regulated, insurance-covered medical services have risen in price by 140%. LASIK has been subject to the market forces of supply and demand while the rest of medicine has been relieved of that burden by government interference.

    More government control is not the answer. Informed, price-conscious choices by medical consumers who are able to make the best choices for themselves is what brings down prices even as quality of service goes up.

  6. I completely agree that the problem is in lobbying. My main political attention is in that area. I often say there is only one political issue, money in govt, because all other issues happen under that umbrella, and our conversation is a case in point. …. And maybe you hate insurance companies as much as I do. You are correct in what you say, but we disagree on the solution. An optional lasik surgery is not a good comparison. If we were to eliminate any “insurance” many people would go without basic care and die. We have to have something akin to insurance, and I continue to compare insurance for profit with govt that works for me.

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